COLONIC DILATATION DUE TO DIALYSIS-RELATED AMYLOIDOSIS

A 66-year-old woman with chronic renal failure who had undergone hemod ialysis for 15 years developed severe dilatation of the ascending and transverse colon. She had received right carpal tunnel release 5 years before this episode. The follow-up study of upper gastrointestinal se ries disclosed marked dilatation of the ascending and transverse colon with the retention of gastrografin persisted for 5 days, whereas colo nic fiberscope showed no obstructive lesion. Pathologic study of biops y specimens obtained from the colon demonstrated amyloid deposition. A vidin-biotin peroxidase complex method showed that these deposits stro ngly reacted with the antibody to human beta(2)-microglobulin, but did not react with AA, lambda, and kappa antibodies. This case suggests t hat dialysis-related amyloidosis can cause intestinal pseudo-obstructi on. (C) 1995 by the National Kidney Foundation, Inc.